The Quality Healthcare Alliance (QHA) believes in a principle-based transformation guided by an electronic health information infrastructure to promote improvements in health. QHA has grasped the need for the industry to shift to a patient centered care model and the importance of providing information to the patient as a tool for managing health. QHA understands that access to timely, relevant, reliable, and secure health information is the missing link for bringing such a focus to the forefront. The health information exchange (HIE) QHA envisions will be the catalyst for transforming health care to a state where quality and wellness, not illness, is the focus. The HIE will provide the infrastructure and tools to close the gap between what we actually do in the health care industry and what we know should be accomplished. The specific aims of the project are: [unreadable] 1) To deploy an HIE to the three rural islands of the state of Hawaii: Maui, Kauai, and the island of Hawaii. [unreadable] 2) To alter the focus of health care from care delivery to prevention, so that the responsibility of health improvement shifts from the current physician focus on illness to a patient-centered focus on wellness. [unreadable] 3) To demonstrate that improving clinical outcomes is the key to resource consumption management, which in turn creates value for an HIE. [unreadable] [unreadable] To accomplish these aims, we will implement both patient and physician incentives based on evidence based clinical measures. We have broad support for this program from the business community, the physicians, pharmacies, the health insurance plans, politicians, and local government agencies. [unreadable] [unreadable]